Madison Rae Mick, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901600158 Issued in MI

Practice address

1951 Oak St
Niles, MI 49120-3738

Phone

(269) 262-4749

Fax

(269) 262-4739

NPI assigned

Jun 27, 2019

Last updated

Aug 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeland Immediate Care Center

  dba Cassopolis Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Cassopolis, MI
  • NPI 1982677548
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1043871254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 OAK ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491203738",
            "telephone_number": "269-262-4749",
            "fax_number": "269-262-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 OAK ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491203738",
            "telephone_number": "269-262-4749",
            "fax_number": "269-262-4739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 N Saint Joseph Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491202263",
            "country_code": "US",
            "telephone_number": "269-262-0399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICK",
        "first_name": "MADISON",
        "middle_name": "RAE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michiana Hematology Oncology of Michigan, P.C.
• Michiana Home Care, LLC (Michiana Home Care)
• Michiana Mobility LLC (Michiana Mobility)
• Michiana Mobility LLC (Michiana Mobility)
• Michiana Spine, Sports & Occupational Rehab, PC
• Midwest Recovery and Wellness LLC
• Midwest Wellness LLC (Nora)
• Mike Flewelling DDS PLC
• Marc Thomas Milhander, PH.D.
• Aubree Miller

• General Practice Dentistry in Niles, MI
• Providers in Niles, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.